About Chronic Fatigue Syndrome

Let’s face it, most of us push ourselves too hard and burn the candle at both ends — as well as in the middle. We work a ton, chase the kids and animals, and prowl the grocery store at night. We run around days and weekends, go out for adult play, stay up late, and simply don’t get enough sleep.

Of course we’re tired. Even if we try to eat healthfully, exercise regularly and get better-than-average sleep, fatigue may set in. It could be stress related, a nutritional deficiency, or poor sleep hygiene ranging from sleep apnea to bad late-night eating habits. Sleep supplements and more rest may help; but what happens when nothing appears to be working and the fatigue gets so bad that it interferes with your job, your family or school time, and causes you to make mistakes, or worse, endanger yourself or others?

Chronic Fatigue Syndrome (CFS), sometimes called myalgic encephalomyelitis (ME), is a condition that makes you feel so tired that you can’t do all of your normal, daily activities. There are other symptoms too, but being very tired is the main one. Some people have severe fatigue and other symptoms for many years.

Your being tired isn’t just in your head . . . it may be your body’s reaction to a variety of factors. CFS is not well understood — most experts now believe that it is a separate illness with its own set of symptoms.

Most CFS patients have some form of sleep dysfunction. Common sleep complaints include difficulty falling asleep, hypersomnia (extreme sleepiness), frequent awakening, intense and vivid dreaming, restless legs, and nocturnal myoclonus (night-time muscular spasm). Most CFS patients report that they feel less refreshed and restored after sleep than they felt before they became ill.

Doctors don’t know what causes CFS. Sometimes it begins after a viral infection, but there is no proof of any connection. It’s likely that a number of factors or triggers come together to cause CFS, but since there are no tests for CFS, it is difficult to determine. Because of this, many people have trouble accepting their disease or getting their friends and family to do so.

Extreme tiredness, or fatigue, is the main symptom. If you have CFS:

You may feel exhausted all or much of the time.

You may have problems sleeping. Or you may wake up feeling tired or not rested.

It may be harder for you to think clearly, to concentrate, and to remember things.

You may also have headaches, muscle and joint pain, a sore throat, and tender glands in your neck or armpits.

Your symptoms may flare up after a mental or physical activity that used to be no problem for you. You may feel drained or exhausted.

Depression is common with CFS, and it can make your other symptoms worse. Since there are not tests for CFS, doctors can diagnose it only by ruling out other possible causes of your fatigue. And since so many other health problems can cause fatigue, most people with fatigue have something other than chronic fatigue syndrome.

Doctors can help people with CFS adopt good sleep habits. Patients are advised to practice standard sleep hygiene techniques, such as:

Establish a regular bedtime routine

Avoid napping during the day

Incorporate an extended wind-down period

Use the bed only for sleep and sex

Schedule regular sleep and wake times

Control noise, light, and temperature

Avoid caffeine, alcohol, and tobacco

Try light exercise and stretching earlier in the day, at least four hours before bedtime, because this may also improve sleep.

While there is no treatment for CFS itself, many of its symptoms can be treated. A good relationship with your doctor is important. That’s because the two of you have to work together to find a combination of medicines and behavior changes that will help you get better. Some trial and error may be needed, because no single combination of treatments works for everyone. If you believe you may have CFS, speak with your physician as soon as possible, and consider meeting with a behavioral health counselor as well.